title: Adolescents in Primary Care with Sub-Threshold Depressed Mood Screened for Participation in a Depression Prevention Study: Co-Morbidity and Factors Associated with Depressive Symptoms.
abstract: OBJECTIVE
  Adolescents in primary care with sub-threshold depression symptoms may be candidates for early intervention to prevent onset of full major depressive disorder. Little is known about this population.
  
  
  METHODS
  We screened consecutive adolescents (ages 14-21) in 13 primary care sites for presence of depression symptoms for "at least a few days" or "nearly every day" in the last two weeks for possible enrollment in a primary care/Internet-based depression prevention intervention (CATCH-IT). We report illness severity, prevalence of self-harm ideation, prevalence correlates (automatic negative thoughts, generalized self-efficacy, perceived social support from family and friends) and co-occurring symptoms of other mental disorders with depressed mood.
  
  
  RESULTS
  Twenty-one percent (N=293) of those screened reported a core symptom of depressive disorder of which 83 enrolled in the study and were analyzed. The sample was 40% ethnic minority with a mean zip code household income of $40,249 (SD=$14,500). Reporting at least one symptom of another mental disorder was common for anxiety (48%, N=40), substance abuse (31%, N=15), conduct disorder (71%, N=53), as were self-harm ideation (16%, N=12) and reporting school impairment (100%, N=83). Prevalence correlates for current depressive symptoms included low self-efficacy, automatic negative thoughts, perceived low peer acceptance, and school impairment.
  
  
  CONCLUSIONS
  Adolescents with sub-threshold depressed mood have frequent co-morbid symptoms that may need to be considered in developing prevention interventions. Early intervention targets to reduce depressed mood include pessimistic thinking, low self-efficacy, low peer acceptance, and school impairment.
authors.affiliation: Department of Medicine, The University of Chicago, Chicago, Illinois, USA ; Department of Psychiatry, The University of Chicago, Chicago, Illinois, USA ; Department of Pediatrics, The University of Chicago, Chicago, Illinois, USA.
authors.forename: Benjamin W
authors.initials: BW
authors.lastname: Van Voorhees
authors.forename: Stephanie
authors.initials: S
authors.lastname: Melkonian
authors.forename: Monika
authors.initials: M
authors.lastname: Marko
authors.forename: Jennifer
authors.initials: J
authors.lastname: Humensky
authors.forename: Joshua
authors.initials: J
authors.lastname: Fogel
keywords: Depressive disorder; adolescents; attitudes; epidemiology; intervention; primary care